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Thunderclap headache attributed to reversible cerebral vasoconstriction: view and review
Marcelo M Valença1, Luciana P A Andrade-Valença, Carlos A Bordini
1Division of Neurology and Neurosurgery, Department of Neuropsychiatry, Federal University of Pernambuco, Recife, PE, Brazil. mmvalenca@yahoo.com.br
The Journal of Headache and Pain
|August 1, 2008
Summary
Thunderclap headache attributed to reversible cerebral vasoconstriction (THARCV) is a neurological syndrome predominantly affecting middle-aged women. While some cases resolve benignly, THARCV can unpredictably lead to stroke.
Area of Science:
- Neurology
- Neuroscience
- Vascular Neurology
Background:
- Thunderclap headache attributed to reversible cerebral vasoconstriction (THARCV) is an emerging neurological syndrome.
- Understanding its clinical and radiological characteristics is crucial for diagnosis and management.
Purpose of the Study:
- To review the clinical-radiological findings of 25 patients diagnosed with idiopathic THARCV syndrome.
- To characterize the presentation, risk factors, and outcomes of THARCV.
Main Methods:
- Retrospective review of clinical and radiological data from 25 reported patients with THARCV.
- Analysis of patient demographics, headache characteristics, precipitating factors, and neurological outcomes.
Main Results:
- The study included 72% women, with a mean age of 39.4 years.
- Headaches were severe, abrupt, and often recurrent. Migraine history was present in 52% of patients.
- 48% of patients developed focal neurological signs, including ischemic stroke in 44% and seizures in 8%.
Conclusions:
- THARCV syndrome preferentially affects middle-aged female migraineurs.
- The prognosis is unpredictable, ranging from benign to leading to stroke.
- Early recognition and further research are warranted for this potentially frequent neurological disturbance.
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